目的 研究沉默晚期糖基化终产物受体(receptor for advanced glycosylation end products,RAGE)对人卵巢癌细胞株增殖、凋亡能力及周期分布的影响.方法 人上皮性卵巢癌SKOV-3细胞经过慢病毒载体构建,分为空白组、过表达组和沉默组.进行细胞增殖、细胞凋亡、细胞周期实验,Western Blot检测B淋巴细胞瘤-2(B-cell lymphoma-2,Bcl-2)、Bax、周期蛋白依赖性激酶4(cyclin-dependent kinase4,CDK4)、细胞周期蛋白D1(Cyclin D1)表达.结果 沉默组24h、48h、72h细胞增殖率低于空白组和过表达组各时间段的细胞增殖率;沉默组各时间段细胞增殖率逐渐降低(P<0.05).沉默组24h、48h、72h细胞凋亡率高于空白组和过表达组各时间段的细胞凋亡率(P<0.05);沉默组、空白组和过表达组各时间段细胞凋亡率逐渐升高(P<0.05).沉默组G1期细胞率低于过表达组和空白组;沉默组S期细胞率低于过表达组和空白组;沉默组G2期细胞率高于过表达组和空白组(P<0.05).沉默组Bcl-2、CDK4蛋白表达高于空白组和过表达组,Bax、Cyclin D1蛋白表达低于空白组和过表达组(P<0.05).过表达组Bcl-2、CDK4蛋白表达低于空白组,Bax、Cyclin D1蛋白表达高于空白组(P<0.05).结论 沉默RAGE通过调控Bcl-2、Bax、CDK4、Cyclin D1相关蛋白表达,能抑制卵巢癌细胞增殖,促进其凋亡,阻碍G2至M期转化,为临床治疗卵巢癌寻找有效的靶向治疗途径.

目的:探讨2-甲氧基雌二醇(2ME2)对缺血缺氧诱导的大鼠心肌细胞凋亡的影响,以及可能的机制.方法:清洁级健康雄性,成年,SD大鼠40只,随机分为假手术组、模型组、溶媒组和2ME两组,每组10只,构建大鼠急性心肌梗死模型,2ME两组在大鼠苏醒3h内按24 mg/kg剂量腹腔注射2ME2,溶媒组和模型组则给予等量的二甲基亚砜或0.9％氯化钠溶液,1次/d,连续7d,建模后第8天时,检测各组大鼠心脏功能,TUNEL法检测各组大鼠心脏梗死区心肌细胞凋亡情况,Western blot法检测各组大鼠心脏梗死区心肌组织中HIP-1α和BNIP3蛋白表达.结果:模型组和溶媒组大鼠LVEDD和LVESD均高于假手术组,而LVEF和FS均低于假手术组(P＜0.05),2ME两组大鼠LVEDD和LVESD均低于模型组和溶媒组,而LVEF和FS均高于模型组和溶媒组(P＜0.05);模型组和溶媒组大鼠心脏梗死区心肌细胞凋亡率均高于假手术组(P＜0.05),2ME两组大鼠心脏梗死区心肌细胞凋亡率低于模型组和溶媒组(P＜0.05);模型组和溶媒组大鼠心脏梗死区心肌组织中HIP-1α和BNIP3蛋白相对表达量高于假手术组(P＜0.05),2ME两组大鼠心脏梗死区心肌组织中HIP-1α和BNIP3蛋白相对表达量低于模型组和溶媒组(P＜0.05).结论:2ME2可减少缺血-再灌注损伤大鼠梗死区心肌细胞凋亡,改善心脏功能,其机制可能与抑制HIP-1α及其靶基因BNIP3表达有关.

目的 探讨平均血小板体积(MPV)联合Gensini评分预测急性ST段抬高型心肌梗死(STEMI)患者急诊经皮冠状动脉介入术(PCI)近期预后的价值.方法 对186例接受急诊PCI治疗的STEMI患者,术前完善相关实验室检查、检测MPV,并根据冠状动脉造影检查结果进行Gensini评分;术后随访记录主要不良心血管事件(MACE)发生情况,并进行统计学分析.结果 186例中,PCI术后36例发生MACE(MACE组),150例未发生MACE(非MACE组).2组间总胆固醇(TC)、血小板计数(Pit)、D-二聚体、N末端脑钠肽前体(NT-proBNP)、MPV、Gensini评分及病变累及冠状动脉3支血管的比例差异均有统计学意义(P均＜0.05).MPV、Gensini评分、Plt、NT-proBNP及病变累及冠状动脉3支血管是STEMI患者PCI术后发生MACE的独立危险因素(P均＜0.05).以MPV(阈值0.86 fl)联合Gensini评分(阈值82.17分)预测STEMI患者急诊PCI术后发生MACE的ROC曲线AUC为0.92[95 ％CI(0.87,0.98)],敏感度为92.70％,特异度为83.33％.结论 STEMI患者急诊PCI术后近期MACE的发生与术前MPV及Gensini评分有关;MPV联合Gensini评分可用于筛查PCI术后高危患者.

目的 探讨血清胃蛋白酶原(PG)Ⅰ、PGⅡ、miRNA-21、let-7a检测对胃癌的诊断价值.方法 选择75例胃癌患者(研究组)和同期60例健康体检者(对照组),应用全自动化学发光分析仪检测两组受试者的血清PGⅠ、PGⅡ水平,实时荧光定量逆转录聚合酶链反应(qRT-PCR)检测血清miRNA-21、let-7a水平,分析血清PGⅠ、PGⅡ、miRNA-21、let-7a检测对胃癌的诊断价值.结果 研究组的血清PGⅠ、let-7a水平及PGⅠ/PGⅡ均明显低于对照组,血清miRNA-21水平明显高于对照组,差异均有统计学意义(P﹤0.01).不同TNM分期胃癌患者的血清PGⅠ、miRNA-21水平和PGⅠ/PGⅡ比较,差异均有统计学意义(P﹤0.01).PGⅠ、PGⅠ/PGⅡ、miRNA-21、let-7a诊断胃癌的受试者工作特征(ROC)曲线下面积(AUC)分别为0.884、0.786、0.803、0.805.PGⅠ、PGⅠ/PGⅡ、miRNA-21、let-7a以及PGⅠ联合miRNA-21诊断早期(Ⅰ～Ⅱ期)胃癌的AUC分别为0.883、0.782、0.776、0.780和0.904,其中PGⅠ联合miRNA-21检测的诊断效能最高.Logistic多因素分析结果显示,血清PGⅠ和miRNA-21是早期胃癌发生的独立影响因素(OR=1.53、1.43,P﹤0.05).结论 PGⅠ、PGⅡ、miRNA-21、let-7a等生物标志物在胃癌患者的血清中异常表达,PGⅠ对早期胃癌的诊断效能较高,其与血清miRNA-21联合检测可提高早期胃癌的诊断效能.

目的:评估急性心肌梗死(AMI)患者血浆miRNA-21、miRNA-29b和miRNA-92a水平与左心室重构及预后的相关性.方法:根据纳入及排除标准纳入57例AMI患者作为AMI组及健康体检者20例作为对照组,检测两组受试者血浆miRNA-21、miRNA-29b和miRNA-92a相对表达量,检测AMI患者发病1d及6个月时的心室重构指标,分析miRNA-21、miRNA-29b和miRNA-92a水平与左心室重构的相关性.对AMI患者随访6个月,采用受试者工作特征(ROC)曲线分析上述指标的诊断价值及最佳阈值,并根据最佳阈值将患者分为高表达组和低表达组,采用Kaplan-Meier生存曲线分析不同表达水平的miRNA-21、miRNA-29b和miRNA-92a表达患者无新发主要心脏不良事件(MACE)生存情况.结果:AMI组血浆miRNA-21、miRNA-29b和miRNA-92a相对表达量显著高于对照组(P＜0.001).AMI组患者血浆miRNA-92a水平与LVESV、LVEDV呈显著正相关(P＜0.05),与LVEF呈显著负相关(P＜0.05).血miRNA-92a对AMI的诊断价值的ROC曲线下面积为0.851,血浆miRNA-92a诊断最佳阈值为41.30,将miRNA-92a≤41.30的14例AMI患者视为低表达组,余43例视为高表达组,结果显示高表达组患者新发MACE事件显著多于低表达组(x2 =4.272,P=0.039),提示miRNA-92a高表达组预后较差.结论:AMI早期患者血浆miRNA-21、miRNA-29b和miRNA-92a水平显著升高,而miRNA-92a与AMI左心室重构及预后严重程度呈正相关,miRNA-92a可作为患者临床AMI诊断和预后监测指标.

目的 分析维格列汀联合美托洛尔治疗冠心病合并2型糖尿病患者的临床疗效及对心功能的影响.方法 选择本院收治的120例冠心病合并2型糖尿病患者作为研究对象,按照随机法将其分为甲乙两组,每组各60例.乙组患者使用美托洛尔治疗,甲组患者在此基础上联合维格列汀治疗,对比两组患者的治疗效果.结果 治疗前两组患者心功能指标比较,差异不具有统计学意义(P＞0.05);治疗后甲组患者LVEF、E峰、E/A各项水平明显高于乙组,LVEDD、A峰水平明显低于乙组,差异具有统计学意义(P＜0.05);甲组患者临床总有效率为95.00％,明显高于乙组76.67％,差异具有统计学意义(P＜0.05).结论 维格列汀联合美托洛尔治疗冠心病合并2型糖尿病患者效果显著,可有效缓解临床症状,改善患者心功能,值得应用及推广.

目的:探究益气活血方联合三联疗法对气虚血瘀型慢性萎缩性胃炎(CAG)患者炎性反应和血液流变学的影响.方法:选取2016年1月至2017年12月新乡市中心医院收治的气虚血瘀型CAG患者160例纳入研究.按照随机数字表法分为对照组和观察组,每组80例,对照组予以奥美拉唑、阿莫西林以及克拉霉素三联疗法治疗,观察组在此基础上联用益气活血方,2组均治疗8周,比较2组临床疗效、临床症状的改善情况以及不良反应发生情况,比较治疗前和治疗8周后炎性反应递质、血液流变学.结果:观察组的总有效率为95.00％,明显高于对照组的85.00％(P<0.05).观察组痞满、脘痛、纳呆、嗳气、乏力、上腹压痛及舌象的总改善率均高于对照组(P<0.05).治疗8周后观察组的白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、表皮生长因子(EGF)、白细胞介素-32(IL-32)及转化生长因子-β1(TGF-β1)水平均明显低于对照组,血浆黏度、全血黏度、红细胞沉降率及纤维蛋白原水平也明显低于对照组(P<0.05).观察组的不良反应总发生率为5.00％,与对照组的8.75％比较,差异无统计学意义(P>0.05).结论:气虚血瘀型CAG患者采用益气活血方联合三联疗法治疗安全有效,并对其机体的炎性反应和血液流变学也有较好的改善作用,有助于更好地促进患者的康复.

目的:探讨清和安胃汤联合四联疗法治疗HP(幽门螺杆菌)相关性胃病的临床效果.方法:将本院门诊及病房诊治的HP相关性胃病病人260例随机分为治疗组和对照组各130例,对照组应用抗HP四联疗法,治疗组在对照组治疗的基础上添加清和安胃汤.停服所有药物,1mo后评估临床症状改善情况、复查C13检测HP根除率及胃镜下粘膜修复程度.结果:①治疗后,两组病人嗳气返酸、胃脘疼痛、胸肋闷胀、口干口苦、饮食减少等症状均不同程度减轻;治疗组有效率优于对照组,差异有统计学意义(P＜0.05);②治疗组HP清除率高于对照组(P＜0.05);③做胃镜复查,治疗组溃疡愈合率高于对照组,(P＜0.05).结论:清和安胃汤联合四联疗法能够改善HP相关性胃病的临床症状,改善炎症和促进溃疡愈合,能够提高HP清除率,降低溃疡和HP的远期复发率,治疗效果优于单纯西药治疗,用药安全效果显著,值得临床推广应用.

Objective To investigate the value of procalcitonin (PCT) levels, white blood cell count(WBC) combined with nine-item assay for combined detection (NACD) in diagnosis of respiratory tract infections(RTI).Methods From January 2014 to December 2015, 435 RTI patients were randomly selected.According to original body category, the patients were divided into bacteria infection group (n=185) and non-bacteria infection group (n=250).The IgM antibody and phlegm training positive rates, serum PCT levels, and WBC counts, serum PCT levels, and WBC counts separate detection and joint detection of sensitive degrees, and specific degrees, different type IgM antibody infection disease original body distribution were analyzed.Results The positive rate of bacterial infection in sputum culture (41.62%) was higher in bacteria infection group than that in non-bacterial infection group (7.60%), IgM antibody positive rate (9.73%) was less than that in the non-bacterial infection group (54%), there were significant differences (P<0.05).The serum PCT levels and WBC counts were higher in bacteria infection group than those of non-bacterial infection group, there were significant differences (P<0.05).The single specificity, sensitivity of serum PCT level, WBC count detection was lower than those of the combined PCT, WBC count detection, and there were significant differences (P<0.05).The original body of different type IgM antibody infection was as the follows, pneumonia accounting for 62.09%, Deputy flu virus accounting for 10.46%, and respiratory collection cell virus accounting for 8.5%, and addicted to lung Regiment bacteria serum I type accounting for 7.84%, and b type flu virus accounting for 7.84%, and pneumonia clothing original body accounting for 3.92%, and gland virus accounting for 2.61%, and Q hot rickettsia accounting for 1.96%.Conclusions The combined detection of PCT, WBC and NACD in the diagnosis of RTI, can improve the clinical diagnosis rate, accurately determine the types of pathogens, has great value in clinical appropriate selection and use of drugs, avoid overuse of antibiotics.

目的:探讨C-反应蛋白(CRP)检测和血细胞比容(HCT)检测在急性胰腺炎患者中的临床诊断效果及应用价值.方法:对某院收治的80例急性胰腺炎患者的病例资料进行回顾性分析,将患者依据病情的程度不同分为重症组40例与轻症组40例,同时将同期在我院进行体检的40名健康人士作为对照组,分别对3组行CRP检测与HCT检测,并对检测结果进行统计对比;同时观察单一的CRP检测、单一的HCT检测及CRP联合HCT检测在重症急性胰腺炎患者中的诊断效果.结果:轻、重症急性胰腺炎的CRP水平及HCT水平显著高于健康人的CRP,HCT水平,同时重症急性胰腺炎患者的CRP及HCT水平又明显高于轻症急性胰腺炎患者的CRP水平及HCT水平;CRP联合HCT检测在急性胰腺炎患者诊断中的敏感度、特异度、阳性预测值及阴性预测值均明显高于单一的CRP检测与单一的HCT检测.结论:CRP及HCT水平能对急性胰腺炎患者的病情程度进行有效评估,临床上可以将CRP及HCT水平作为急性胰腺炎的有效诊断指标,而CRP与HCT联合检测的敏感度、特异度、阳性预测值及阴性预测值比单一的检测方式更高,因此CRP与HCT联合检测可作为急性胰腺炎患者的首选诊断方式.

Objective:To investigate the expression and the clinical significance of interleukin-23 (IL-23) and interleukin-15 (IL-15) in serum of patients with Henoch-Schoenlein purpura (HSP).Methods:From Mar.2014 to Dec.2016,41 patients with HSP admitted in Puyang Hospital of Traditional Chinese Medicine (observation group) and 37 healthy subjects (control group) were involved in present study.Fasting venous bloods were sampled from the both groups after admission to detect serum IL-23 and IL-15 levels.Two weeks after treatment,patients in HSP group were divided into 2 groups according to the clinical efficacy as effective group (n=29) and ineffective group (n=12),the blood samples were then taken again for detection and comparison of serum IL-23 and IL-15 levels.Results:The levels of serum IL-23 and IL-15 were significantly higher in observation group than in control group with statistical significance (P＜0.05).Two weeks after treatment,the levels of serum IL-23 and IL-15 were significantly lower in effective group than in ineffective group with statistical significance (P＜0.05).Conclusion:IL-23 and IL-15 may take part in the pathogenesis of HSP,and detection of serum IL-23 and IL-15 levels may be in favour of evaluating the therapeutic effect of HSP.

目的:分析新型溶血素与传统溶血素在临床血液分析中的应用价值及其检验结果.方法:收集2014年12月—2015年12月我院接诊的进行血常规检验的200例健康体检人群作为研究对象,采集所有患者的空腹静脉血2~3 mL,将抽血的血液标本平均分装于两支试管中,且将分装的两组标本分别作为实验组与对照组,均为200份.实验组标本采用新型溶血素进行血常规检验;对照组标本采用传统溶血素进行血常规检验.观察及比较两组标本的红细胞(RBC)、白细胞(WBC)、血小板计数(PLT)及血红蛋白计数(Hb)等指标情况.结果:实验组对象的Hb含量为(143.12±4.96)g/L,明显高于对照组的(119.53±6.41)g/L,实验组对象的RBC为(5.87±0.49)×109/L,明显高于对照组的(3.70±0.56)×109/L,(P<0.05)差异存在统计学意义.而两组对象的WBC与PLT对比,(P>0.05)差异无统计学意义.结论:新型溶血素在血液分析中的应用价值明显优于传统溶血素,安全可靠.如检测过程中血红蛋白水平升高时,应及时调整因数进行纠正.

目的：探讨不同病变程度的酒精性肝病(ALD)患者血浆同型半胱氨酸(HCY)水平的差异。方法选择ALD患者200例，根据病理结果分为4个试验组：酒精性脂肪肝组85例，酒精性肝炎组68例，酒精性肝纤维化组23例，酒精性肝硬化组24例，并选取健康体检者200例作为对照组，检测标本血浆中的HCY。结果酒精性脂肪肝组、酒精性肝炎组、酒精性肝纤维化组、酒精性肝硬化组HCY值均高于对照组，差异均有统计学意义(P<0.05)；酒精性脂肪肝组和酒精性肝炎组比较，差异无统计学意义(P>0.05)，酒精性肝纤维化组和酒精性肝硬化组均高于酒精性脂肪肝组和酒精性肝炎组，差异均有统计学意义(P<0.05)。结论ALD患者HCY水平的高低可反映肝功能损害程度，对ALD的诊断、治疗具有监测价值。

Objective To evaluate the clinical effect and method of LCP internal fixation for the treatment of fractures of the distal radius under the pronator quadratus. Methods From April 2008 to January 2001, by the volar approach with reservation of pronator, the unstable distal radius fractures were treated by LCP internal fixation inserted under the pronator quadratus in 17 cases, according to AO classification: type B1 2 cases, type B2 7 cases, type B3 2 cases, type C1 in 4 cases, 2 cases of C2 type. All the cases were taken by volar approach, pronator quadratus were reserved, or only to cut off partly and LCP internal fixation were inserted under pronator to treat distal radius fractures. Results The patients were followed up for 9~44 months, with the average of 13 months. All fracture healed, the average healing time was 7 weeks. No infection, nonunion, carpal tunnel syndrome and other complications occurred. According to the improved Mcbride wrist joint function evaluation standard: excellent in 15 cases, good in 1 case, moderate in 1 case, the excellent and good rate was 94.1%. Conclusion The LCP internal fixation inserted under the pronator quadratus for treatment of distal fractures is completely feasible, in line with the point of view of modern minimally invasive operation. Pronator can cover the plate, reduces interference of wrist tendon, reduce tissue injury, to maximize the retention of forearm rotation function, is advantageous to the recovery of wrist function.

Objective: To observe the effect of Xuezhikang capsule on the inflammatory factors,endothelial function and carotid atherosclerotic plaques(CAP) in patients with unstable angina pectoris(UAP).Method: Eighty-two cases of UAP and CAP patients were randomly divided into two groups: the control group received conventional therapy + rosuvastatin,Xuezhikang group received Xuezhikang capsule,2 capsules once,three times daily,based on the control group.Both groups were given continuous medication for 12 months.Lipids,inflammation,endothelial function indicators and CAP were detected before and after treatment,clinical efficacy in patients of two groups were observed after 12 months of treatment,cardiovascular events were followed up for 12 months.Result: After 12 months of treatment,the total efficiency of Xuezhikang group was significantly higher than that of the control group(P 0.05);there were significant differences between the two groups and the health group in blood lipids,inflammation,endothelial function and intima-media thickness(IMT) values and the area of the CAP(all P 0.01);the improvement of blood lipids,inflammation,endothelial function and IMT values and the area of the CAP in Xuezhikang group was significantly better than that of the control group(all P 0.01);the incidence of cardiovascular events of Xuezhikang group was significantly lower than that of the control group(P 0.05);there was no significant difference between two groups in the incidence of adverse drug reactions.Conclusion: Xuezhikang reduce cardiovascular events by improve endothelial function,reducing the inflammatory response,reversal and stable carotid atherosclerotic plaque,and no increase in adverse effects.

目的研究与探讨使用复方丹参滴丸治疗冠心病心律失常的疗效。方法将128例冠心病心律失常患者按意愿分成两组,观察组使用复方丹参滴丸治疗,对照组采用盐酸胺碘酮片治疗,疗程结束后比较两组治疗效果。结果观察组在疗效及心电图效果上均与对照组有显著性差异,差异有统计学意义(P<0.05)。结论使用复方丹参滴丸治疗冠心病心律失常疗效显著,无不良反应,值得临床推广。

目的对危险因素在中青年患者中的分布情况进行分析评价,为此给中青年预防冠病提供理论基础。方法将两年内(2010-12年6月)在我院50例通过冠脉造影确诊的冠心病患者用来作为治疗组,40例通过冠脉造影或者心脏ECT检查都正常的中青年人作为对照组,对照组和观察组的家族史、高血糖、高血脂、高血压、吸烟情况等危险因素进行比较和对比。结果观察组有40人吸烟,占的比例是80%,而对照组所选的40人中有8人吸烟,所占的比例是20%。有家族史者在观察组以及对照组中各36%和20%,各18和8例。每组有一名高血压患者。观察组各项指标包括TC、TG、Lp(A)的水平和家族史、患者吸烟率均高于对照组,差异具有统计学意义(P<0.05)。结论中青年患有冠心病最有可能是跟TC、TG、Lp(a)水平的高低有关,这些指标升高或者综合起来都是其高危险因素。

目的研究铜鲍曼不动杆菌(Ab)在重症监护病房的分布、耐药趋势、感染因素及防治措施。方法分析近3年Ab在重症监护病房的分布,采用K-B法进行药敏试验,并与同期环境监测结果对比分析Ab感染的感染因素。结果 Ab所感染的重症监护患者(≥65岁)3年中比率均超过了75%,多重耐药的Ab比率不断上升,免疫功能低下、气管切开和机械通气等已成为了感染的主要危险因素,呼吸机型肺炎是重症监护病房感染Ab的主要因素之一。结论Ab是中医院重症监护病房主要感染菌,控制Ab感染既要重视防,减少其侵入的机会,做好院感控制工作;又要重视治,合理应用抗生素,降低Ab感染的发生率和病死率。

<正>2009年2月～2010年10月,我院对64例轻中度骨性关节炎患者中32例经关节镜清理术后应用盐酸氨基葡萄糖治疗,32例进行单纯关节镜手术治疗,比较两种方式疗效,报道如下。

目的探讨曲美他嗪对不稳定型心绞痛(UAP)并糖尿病患者血管内皮功能和心功能的影响。方法选取UAP并糖尿病患者80例,随机分为治疗组(40例)和对照组(40例),对照组给予常规治疗,治疗组在对照组治疗的基础上加用盐酸曲美他嗪,两组均治疗6个月。治疗前后检测血管内皮功能[血浆内皮素(ET)、一氧化氮(NO)、肱动脉血流介导内皮依赖性血管舒张功能(FMD)]和心功能指标[心输出量(CO)、心室舒张早期二尖瓣血流峰值和舒张晚期二尖瓣血流峰值之比(E/A)、左室射血分数(LVEF)]的变化。结果治疗后治疗组ET、NO、FMD、CO、E/A、LVEF分别为(44.68±5.80)ng/L、(82.10±10.42)μmol/L、11.09%±0.91%、(4.93±0.91)L/min、0.84±0.13、52.4%±4.5%,各指标的改善均优于对照组[分别为(49.70±6.43)ng/L、(64.25±9.44)μmol/L、10.16%±0.85%、(4.51±0.93)L/min、0.96±0.12、50.1%±4.9%],差异均有统计学意义(P<0.05或P<0.01),治疗组未发生与曲美他嗪相关的不良反应。结论曲美他嗪具有改善血管内皮功能和心功能的作用,无明显的不良反应。